Forty one cases(37 patients) of mandibular reconstruction using AO-plates were reviewed. The patients aged from 27 to 83 years old(52.3f 18.1 years) were followed for 5 to 42 months (mean 12.7 8.3 months). Cases were grouped by the location of reconstruction + Anterior mandible crossing midline as Group A(12 cases), body segment of the mandible as Group B(16 cases), condyle & ramus of the mandible as Group C(13 cases). The incidence of revision as a measure of outcome was calculated by actuarial methods accounting for loss or death.
Revision or plate removal occurred in 22.2% (9 of 41 cases) with an incidence of 52.2% (6 of 12 cases) in Group A. 12.5 % (2 of 16 cases) in Group B. and 7.7 %(1 of 13 cases) in Group C. Combined use of AO-plate and bone graft had a revision rate of 33.3%(4 of 12 cases), while the reconstructions with plate only had a rate of 17.2%(5 of 29 cases). The difference between the immediate reconstructions(19.2% : 5 of 26 cases) and delayed reconstructions(26.7% : 4 of 15 cases) was not significant, but the delayed reconstruction of the anterior mandible resulted in highest failure rate of 57.1 % (4 of 7 cases).
The revision incidence was significantly high when the area had been radiated 33.3% of 24 radiated cases, while 5.7% of not-radiated cases required revision. Particularly, the radiated Group A resulted in remarkable higher failure rate(63.2% of 10 cases). Mouth opening over 30mm was obtained in 92.3 % of Group C, in 63.8 % of Group B, but only in 52.2 % of Group A. Joint pain which was mild and tolerable was noted in 3 of 13 Group C patients.
The large defects of the mandibles following support have been used
massive trauma, resection of refractory osteora- Autogenous corticocancellous bone blocksl)2?
dionecrosis and ablation of tumors lead to defi particulated cancellous bone marrow in allogenic
ciencies in mastication and esthetic function. To bone tray12)14)17)18) and the vascularized bone replace the mandibular defects and to restore the., grafts20 following the composite resection have
function properly, bone graft and/or alloplastic been considered more acceptable than the allop-
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